N-Zone Update

Here are the latest developments regarding my experiment with low-dose naltrexone (LDN).

I’ve taken my medicine every night for 12 nights now; I have a 30-day supply, so I’m nearing the half-way point of this trial period. I was cautioned to not expect any improvement in my CMP symptoms too quickly, and that certainly seems to be wise advice. There has been no “miracle cure” here, for sure.

I believe I am experiencing small, but perceptible changes, however. The most problematic areas for me have been the tingling & numbness in my left foot and the pain my lower back. Although it’s somewhat difficult to tell (due to the “good-day” / “bad-day” nature of the disease), I’ve been starting to think that there is a little improvement. The primary way I have of gauging this is that, at some points during some days recently, I have realized that I’ve not been thinking about the pain. This is pretty incredible, given that most all of the time (in recent days, weeks, months and even years), awareness of the pain is always with me.

I’m hoping that there is some promise in this treatment, but there’s a long way to go. Especially, since I’ve developed additional pain symptoms recently. Given all the time I’ve spent at the computer in the last two to three weeks to address the problems with my former blog, and then getting this version ready to go online, I’ve developed pain in my right forearm and wrist that is consistent with my 1990 tendonitis diagnosis. Amazingly, though, the Trigger Point Therapy Workbook offers me hope that I can treat this with trigger-point massage therapy (and that this may not, after all, be tendonitis but rather part of my CMP condition).

The bottom line of my thinking for today is that there may be some hope for me and my CMP woes as I combine the self-massage and LDN therapies.

End of Life

I received word a couple of days ago that one of my high school classmates does not have long to live. Several years ago she was diagnosed with breast cancer but was able to survive the experience back then. The most recent memory I have of her is from a class reunion where I observed her smoking a cigarette. I must admit, I had a judgment about this. I thought: A cancer survivor. Yet she’s smoking. Incredible. She must have a death wish.

Linda was someone I shared rides with to school in the morning some days (via a carpool). I can’t say that we were really friends, though. We were acquaintances, mostly; we lived in the same neighborhood of our small, rural northern-Wisconsin town and our parents knew each other. She was at least one notch, probably more, above me on the social scale. She was a good looking teenager (rather hot, actually) and dated the jocks. I was extremely average looking, small, non-athletic, academic — and nerdy with a rather rebellious wild side. I didn’t fit. She did.

Now she’s in hospice care. So, again I’m left thinking: what’s this life all about, anyway?

The N-Zone

I’ve talked off and on here about my diagnosis of chronic myofascial pain, provided some thoughts about surviving this disease and the treatment process, and most recently, discussed the trigger-point injection therapy I began a couple of weeks ago.

Here’s a little addendum to the story that I’ll now share with you…

During the first appointment at the doctor’s office where we performed trigger-point injections , skittish-(around-needles)-person that I am, I allowed only four injections. The second time, a few days later, was a session with 19 injections. That extremely-intense ordeal was on a Monday morning, and, as it followed a weekend of suffering through some intense back and foot pain, I experienced some much-needed relief during the course of that day. However, by that evening, I had pretty much returned to “normal.” (This was not a good thing, of course…the pain had returned!) In fact, by the end of the week (on that Friday), I was hurting so much that I made and kept an appointment with my chiropractor in Eugene, where I obtained some pain abatement with the (for me, usual) treatment modes of ultrasound, light massage, and a small chiropractic adjustment.

My injection-therapy doc was going to be out of town for a bit, so the first chance I had to return to him was Monday morning of this week. While there, I reported on my status, including the few-hours-only relief I obtained as a result of the 19 injections last time.

Of course, I had been discouraged at not experiencing more relief as a result of that previous visit, but, still, was rather unprepared for the assessment that injections were not going to be the preferred treatment for me. The “typical patient” tends to respond much more positively than I did, apparently.

I had been warned that this (injection) path might be more problematic for me than others, though. In reporting my medical history, I of course had disclosed that I had been taking lorazepam (“Ativan”) during the last several months in an attempt to cope with the anxiety-factors of my life (job loss, interviewing, moving…that kind of stuff). As it turns out, and as I had been informed, taking a drug in the bezodiazepine class can sometimes (oftentimes) seriously get in the way of having a successful outcome from trigger-point injections. And this doctor, while having treated only a few individuals who were taking (or had taken) this type of drug, had first-hand experience in seeing such cases as mine “fail.” I had been off the drug for a full three weeks at the time of my injections (and, now, as I write this, it’s been over five weeks), but the effect that the drug can have on the body (at least as far as trigger-point injections go) can be much longer lasting than would typically be predicted from the elimination half-life .

So, what to do now? (was the question) I had been studying the Trigger Point Therapy Workbook and doing my own self-massage of trigger points (with the help of a variety of massage “tools” that I now own). But this approach seems to have yielded little progress, especially regarding my back pain. (It’s possible that the condition in my left leg and foot is somewhat improved.)

I asked the doc what we could to do to pursue an alternative treatment path. Fortunately, he had some ideas (several of them, actually). One possible approach that emerged was to take small doses of a drug, naltrexone , once a day (at bedtime) for thirty days. Naltrexone is an “anti-narcotic” usually prescribed to manage alcohol and opiate addiction. However, in low doses (3 mg vs. the typical 50 mg), the drug has been found to be advantageous for a variety of ailments. The hypothesis regarding this drug’s biochemical mechanism (magic?) is that it produces an increase in endorphin levels in the body, which positively impact muscle tissue (and myofascial trigger points, in my case). In people with diseases that are partially or largely triggered by a deficiency of endorphins ( CMP and fibromyalgia are thought to be in this category), or are accelerated by a deficiency of endorphins, restoration of the body’s normal production of endorphins is believed to be the major therapeutic action of (low-dose) naltrexone.

Now, I had never heard of this drug prior to two days ago. But, I admit, this theory and approach are fairly attractive: a low dose of a drug purported to have “no side effects” and that does not involve frequent, multiple and painful needles in my body. Further, the success rate of this approach for individuals with my condition is supposedly quite high (the pharmacist said that, in his experience, this approach works “about 90% of the time”).

I took the first dose last night at bedtime, after discovering that “low-dose naltrexone” (LDN) has its own website and listserv on yahoogroups . I have started to do the reading and the research, though it may be several days before I have any “results” of this experiment to talk about.

Stay tuned for further updates on my naltrexone experience...

Senioritis

Here is a mildly disturbing development in my life...

I drove into town to run an errand during the noon hour today. While there, I decided to have lunch at the Subway shop closest to my apartment. As I was at the register to pay for my turkey sandwich and chips, the young man said, “that’ll be $4.70...or do you do the senior discount?” To which I stammered, “ excuse me ? Uh. No .”

Holy craperino, Batman! This is the first time such a thing has happened to me, and it caught me completely off guard. What, I wondered, about my appearance today , merited this promotion to senior status?!?

Yeah, yeah…I know. I’m 59. I’m an AARP member. I have some gray hair. But, geezzzz. He had to SAY IT OUT LOUD?

Now, I hadn’t had a bad day to that point, and the rest of day went mostly ok too. There is just this one little blip that sticks with me.

Senior discount? Moi?

Anniversary & A Passing

On April 4, 1968, Martin Luther King, Jr., was assassinated in Memphis, TN. Two days later, as the country was experiencing utter turmoil from coast to coast, M and I were married at Trinity Lutheran Church in Eau Claire, WI. If that marriage had lasted, today we would have been celebrating 38 years of married life. Holy smokerinos, do these kinds of thoughts make me feel old!

I now find it interesting that I chose to get married in a year that was one of the most turbulent and definitive ones of the times. M and I went honeymooning when many of the major metropolitan areas of the country were experiencing riots in the aftermath of MLK’s murder. Bobby Kennedy was killed in California just a couple months later; two more months after that was the Democratic National Convention debacle in Chicago. My oh my, the flashbacks I’m having as I write this…

I guess if I can have memories this old, then feeling old, at least at times, isn’t all that surprising.

Lately, the energy I’ve been able to summon to make blog entries (well, actually, just to make it through the day) has waned a tad. Since last week, for sure, I’ve been trying to pace myself even more conscientiously that I usually do. Seeing my life’s blood literally gush from my body in the nosebleed episode had a big impact on me, I think. And, too, I was diagnosed with another eye infection last week. So, I’ve been fighting with that condition, which has led to diminished motivation to stare at a computer screen. Anyway, if you’re out there checking blog entries, you’ll probably have noticed less productivity from ol’ TechnoMonk.

I had a chat with a fellow I work with today. He’s a couple years younger than me, and he disclosed that, physically, he’s been struggling as well. It seems as if his energy level has taken an unexplained, precipitous drop. It wasn’t a gradual thing. Suddenly he’s fatigued all the time. All the medical tests that he’s had so far have turned up nothing; still, this kind of stuff can weigh mightily on one’s mind. I sure know about that firsthand.

It just another example of the fact: we never, really, have any control…

“Seeking security or perfection, rejoicing in feeling confirmed and whole, self-contained and comfortable, is some kind of death…[and is] setting ourselves up for failure, because sooner or later we’re going to have an experience we can’t control: our house will burn down, someone we love is going to die, we’re going to find out we have cancer, a brick is going to fall out of the sky and hit us on the head…to be fully alive, fully human, and completely awake is to be continually thrown out of the nest. To live fully is to be always in no-man’s land…” (Pema Chödrön, When Things Fall Apart, p. 71).

Postscript for the day ... As I was just putting the finishing touches on this entry, the phone rang. My supervisor, who normally does not call me at home, just did. The news is: one of our colleagues, a good man, and a department chair who reported directly to me, died this evening, apparently of a heart-attack. I don’t have the details. I am in shock. More later...